Podcast

All Articles in the Category ‘Podcast’

5 Things That Confirm You’re A Master Parent

After I published my book Mama Doc Medicine, I toyed around with the idea of writing tiny little books inspired by a favorite short story publication, One Story. Literally I was thinking that the way to consume ideas about parenthood was not in book form but in pamphlet-sized publications on parenthood, vaccines, & general tips for feeling awesome while raising children. I haven’t entirely tanked the idea (please weigh in if you think you’d read them!) but it’s not at the top of my to-do list. That being said, I realized after publishing years of blogs and a whole book of stories about my boys and science and parenting and the general overwhelm we all feel, that I could have perhaps just published five tips in five pamphlets! Sure would have saved time…

Thing is, in my opinion, if you do these five things, you’re wildly decreasing the likelihood of death for your child and pretty much preforming at the top 99%, parenthood-wise. All the rest is gravy. As a mom and pediatrician, I think if you do these things well you should feel like a ROCK STAR. The rest of what we all read about is a smattering of parenting “style” advice. There will continue to be books on grit and food selection and poop and sleep forever. And reading up on new ideas and new data can be great ways to bolster our confidence. But really, I’m saying, do these 5 things out of love and with ongoing daily respect for who your child is as an individual, and I think you’ll be a master.

This is the cousin to my recent “5 Things To Stop Worrying About” blog. In my mind, there are five non-negotiable pediatric parenting must-dos. If you can make these things a top priority, you’re pretty much nailing it. Congrats. Check this off on your life list as an awesome new start to spring. Listen to the podcast, please but little notes about it are below, too. Love up your children and love up yourself for doing all of this so well!

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Tongue-Tie And Breastfeeding: What To Do For Babies With Tongue-Tie

Image c/o Mayo Clinic

Tongue-tie is a condition in which an unusually short, thick or tight band of tissue (frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. Often it goes unnoticed and causes no problems in life but rarely it can affect how a child eats and how they sound when they speak, and can sometimes interfere with breastfeeding because baby’s tongue may not have enough range of motion to attach to the breast, suck and swallow effectively. Sometimes tongue-tied babies can’t maintain a latch for long enough to take in a full feeding, and others remain attached to the breast for long periods of time without taking in enough milk. Sometimes babies with tight frenulums make it miserable for mom to feed because of the way they attach and latch. When a newborn has a tight frenulum breastfeeding moms may have nipple pain, mom may hear clicking sound while the baby feeds, or mom may feel it’s inefficient. Sometimes a parent will notice a heart shape to the tip of the tongue as the band of tissue pulls on the tongue where it’s attached.

What to do about tongue-tie can be controversial. Not all pediatricians, Ear, Nose and Throat surgeons, lactation consultants and occupational therapists always agree. However, every baby deserves the chance to be evaluated by both a physician and a board certified lactation consultant if there is concern! Awareness about a newborn’s challenges with breastfeeding increases diagnosis in the newborn period but decisions to clip a tongue-tie come about from a variety of factors. The American Academy of Pediatrics states: “surgery, called frenotomy, should be considered if the tongue-tie appears to restrict tongue movement, such as inability to latch on with breastfeeding. It is a simple, safe, and effective procedure—general anesthesia is not required.” It takes only a few seconds and many pediatricians can perform the clip in their office.

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5 Things To Stop Worrying About

It’s a hard time to be a human in the United States. We’re all so worried right now as the universe seems to spin every day and the divisions among us seem to project on every wall. Yesterday I escaped the city, the news cycle, and dread by sledding with my boys in the mountains. Those outdoor be-without-a-ceiling interludes help, but the reality is Sunday morning just arrived and the newspaper is sitting on the front porch. To open it?

The hesitancy to even open the newspaper brings me to an essential truth: most of us are doing a wonderful job raising our children and what is in front of us is precious and safe. Most of us have inner critics that knock us down every day and criticize how we’re doing. But most of us can stop worrying about things so much at home. We really can and should chill out and enjoy this.

Looking to shorten your to-do list, maybe sleep better and reduce anxiety? I’ve shared 5 things I think we as parents can STOP worrying about in the latest podcast. It’s just me talking in this one (no experts join) and even so, I like this podcast. In a world where were are inundated with competition, guilt, data, and comparisons, take these ideas and feel better about the (likely) most wonderful job you’re doing raising your children.

Also, you should know I’m recording, “5 Things To Perfect As A Parent” this week as I feel we all need reminders of how much we have already mastered. We have to frame-shift and realize how great things really are while raising children amid these spins and unease. Read full post »

If You Worry Your Child Is Depressed

Depression is far more common in teens than in young children, but I often hear families wondering how to know if they should worry about their child’s mood. As many as 1 in 5 teens can have a depressed episode so concerns about depression are a common challenge. Many of us wonder if young kids get depressed (yes, but not too often), what are the signs (detailed below), and what to do about it (6 tips below). It’s scary for every parent who thinks a child is depressed. It can be terrifying to worry about a teen. There is a certain innocence we reserve for childhood and no question for some, depression can seem antithetic to that. Depression can be very real, influenced by life events, inherited, and wildly disruptive. But there is great research to help guide what we do to support children, teens, and our families if depression becomes a challenge.

I talked with clinical psychologist and depression expert at Seattle Children’s Hospital, Dr. Gretchen Gudmundsen on this 20-minute podcast. I learned a lot as we covered the definitions of depression, which children are at risk for depression, classic depression symptoms, and when parents should seek help for their depressed child.

You can listen to the podcast right here on the blog, or you can listen while you’re commuting on your phone by going to iTunes (search “Seattle Mama Doc”) or Google Play or on Soundcloud. A quick summary of high-level points below:

What Is Depression In Children and Teens:

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Mumps! What To Know During An Outbreak

There is a mumps outbreak here in Washington State, as well as various other outbreaks across the nation. The CDC reports that mumps infections are currently at a 10-year high. This post is a quick update on the outbreak and why they occur, an explanation about the mumps virus, the infection and symptoms that are typical, and what parents should know now to avoid mumps.

Mumps Outbreaks In 2016

  • Numbers This Year: For the calendar year 2016 through early December, 46 states and the District of Columbia have reported a total of 4,528 mumps infections — well more than double the mumps cases reported in 2015 and creeping up in ways similar to 2006 when we had the last big mumps year. That outbreak was primarily housed in the midwest among college students.
  • Mumps In College Students: In general, we often hear more about outbreaks on college campuses in part because of students living in close quarters. Mumps is easily spread when those are in close contact who share cups, talk closely together and share respiratory droplets more readily. The intensity of these environments allows mumps to spread more rapidly and it’s also possible that during college some students have lost immunity from the vaccine they received as a child. In general college students are at higher risk because of how they relate. I love how CDC details the conditions, “certain behaviors that result in exchanging saliva, such as kissing or sharing utensils, cups, lipstick or cigarettes, might increase spread of the virus.”
  • Washington State Outbreak: As of 12/23/16 there have been 101 cases in King County (cases updated here by the Public Health Dept). In total, 32 cases are confirmed and 69 probable with additional cases under investigation. The majority of cases are in children under age 18. Some 65% of those cases are in people who are reported as up-to-date on Measles Mumps & Rubella (MMR) vaccine. This occurs in part because although the MMR vaccine works well, it still will leave some vulnerable to an infection if exposed. The MMR vaccine provides protection against mumps to about 88% of us after we get two shots, so it consequently leaves more than 1 in 10 of us vulnerable during outbreaks. We typically don’t know who is in that 12% so during outbreaks we make sure students are up-to-date in immunizations and those with suspicious symptoms are seen, diagnosed, and while infectious, they stay home.
  • Schools Send Children Home If No MMR Shots: The outbreak has been of big enough concern that The Auburn School District told more than 200 non-immunized students to stay home so they wouldn’t get the virus and go on to infect others. Public health officials sent letters to the students’ homes saying kids would only be allowed back once they had proof they’ve received the MMR vaccine. Otherwise, the students will be kept from school for at least 25 days after the last mumps case in the Auburn district.

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HPV Vaccine On Time: Only 2 Doses

hpv-2-doseWelcomed news out this fall about immunizations. If children and teens get their HPV vaccine on-time between the age of 11 and 14 years, they won’t need to do 3 doses as previously recommended. HPV vaccine given, starting at age 11, can be just 2 doses now, spaced 6 months apart! Celebration.

This new HPV shot recommendation from the CDC is based on research that has found when younger children are immunized, their immune response is greater at younger ages (age 11 versus age 16, for example). It’s also based on data on durability of the vaccine response — data has found teens immunized in the “tween” years continue to be protected years and years after the vaccine is given. So don’t wait to get teens immunized! In fact, waiting isn’t safer in any way, just leaves your child open to exposure for a longer period of time and the vaccine has the same side effects (most notably pain at the injection site!). Plus, you’re now reducing the amount of shots your child needs from 3 –> 2. Huge win!

The hope in this new recommendation is three-fold: more teens will get immunized on-time, they’ll be better protected from HPV infections and cancer risks early, and it will be easier to complete the entire series. Last year, for example, about half of boys ages 13 to 17 had gotten at least one of the recommended three doses, while about 63 percent of girls had gotten at least one dose, according to the CDC. However, not all teens finish the series and the new recommendation may help. In some areas only about 1/3 complete it.

HPV vaccine is an anti-cancer vaccine.

If your child has started the HPV series but not completed it, there is no reason to re-start the series — those shots still count. Just schedule a visit to finish what they started. If your child is between age 11 and 15 and there has been 6 months since their last HPV shot, under the new recs they will only need one more dose.
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When Is It ADHD In A Child?

I talked with Erin Schoenfelder, PhD,a specialist in ADHD and Director of Behavioral Treatment at the PEARL Clinic (Program to Enhance Attention, Regulation & Learning) here at Seattle Children’s Hospital, about ways to recognize ADHD in children and teens. The previous post we shared included the acknowledgment that it may be harder to parent a child with ADHD and provided reasons for it along with 5 tips to help parents and families. In the podcast above, Dr. Schoenfelder helps parents, teachers, and pediatricians understand what ADHD is and identifies ways to support, diagnose, and evaluate children with whom parents and teacher hold concern. First and foremost make sure you understand how a child sleeps before doing any further work-ups! Sleep challenges can be a big mimicker of ADHD as deprivation causes inattention and distractibility.

What is ADHD?

  • Developmentally atypical symptoms of inattention and/or hyperactivity/impulsivity.
  • Developmental disorder that persists over time and years and is consistent across settings (i.e. children have challenges at school, at home, during sports activities, at a synagogue or church).

Signs, Symptoms, Red Flags

  • Problems in multiple settings completing work, getting along with others, following directions, and succeeding
  • Teacher noticing the child is standing out from others
  • Child an outlier in a group – soccer practice, birthday parties, home
  • Risky behavior, getting injured due to impulsivity
  • Falling behind in learning due to off-task behavior

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3 Reasons And 5 Tips For Parenting A Child With ADHD

Turns out that in clinical practice I’ve learned that it’s okay to acknowledge that some children are simply harder to parent than others. From what I can tell it’s really true. Often those parents struggling with children with behavioral challenges blame themselves more than is necessary. Sometimes rationale for why it’s harder helps.

There are all sorts of reasons for increased challenge. Chronic or challenging underlying illness, mental health struggles, and/or behavior challenges are a few of the reasons that some parents have a much harder job. I talked with Erin Schoenfelder, Ph.D. a specialist in ADHD and Director of Behavioral Treatment at the PEARL Clinic (Program to Enhance Attention, Regulation & Learning) here at Seattle Children’s Hospital about how parents often NEED a different parenting strategy if their child has ADHD. She outlines it beautifully in the podcast. These 3 reasons and these 5 strategies Dr. Schoenfelder shares can help families support children with the unique challenges that come along with ADHD.

Why do children with ADHD need different parenting strategies?

Normal good parenting strategies (sticker charts, send to room, natural consequences) don’t seem to work for kids with ADHD. Parents need additional strategies. When children with ADHD fail to thrive in typical structures for reinforcement, it doesn’t mean parents are failing. Parenting a child with ADHD can at times be harder than parenting a child without attention challenges.

1. Children may lack internal “self regulation”

  • Kids not regulating their own engines to stay on track. So children with ADHD may be very susceptible to external environments, including distractions, inconsistencies.
  • Therefore, behavior is inconsistent. Kids aren’t able to do what they know how to do.

2. Limited window on time for discipline

  • “Now” versus “Not Now.” Make sure you provide immediate feedback for children with ADHD. If you wait, it may lose relevance or even be lost in the memory bank.
  • Children with ADHD may have a tendency to have their window get “flooded” easily, and they cannot shift forward to predict what will happen next, or backwards to recall what has/hasn’t worked in the past.
  • Children don’t connect behavior and consequence the same way as children without ADHD.

3. Children with ADHD may have different processing of rewards

  • Dopamine is processed differently in the brain of children with ADHD. Therefore when they get the chemical kick of reward, they may experience it differently.
  • Everyday things feel less rewarding and interesting than they are for other kids.
  • Other things (screens) may feel SUPER rewarding…

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Playing Multiple Sports Is Better For Most Children

New data out (that I happen to LOVE) seems to go against many parental instincts, including a few of my own. I think plenty of parents have been led to believe in the last few decades that specialization and mastery in a single sport early in life is GOOD for their children. Some of that instinct rises from our guts in the mis-appointed “10,000 hours rule.” The idea that once our children do something for 10,000 hours they will be an expert. The 10,000 hour rule (brought to masses in part via Malcolm Gladwell) suggests that with dedication and time (10,000 hours) a person will develop mastery over a sport or skill. A recent American Academy of Pediatrics clinical report states, “it has often been misquoted that to succeed, an athlete needs to have 10,000 hours of practice/competition over 10 years. The media have incorrectly extrapolated Ericsson and co-workers’ studies of chess players to a formula for sports success. Many examples exist of successful athletes who have <10,000 hours and others who have not succeeded despite having >10,000 hours of practice/competition.”

Children in sports have changed over the last 40 years.

There is increased pressure to participate at a high level, to specialize in 1 sport early, and to play year-round, often on multiple teams. This increased emphasis on sports specialization has led to an increase in overuse injuries, overtraining, and burnout. ~Dr. Joel S. Brenner

And it’s just not true that grunt hours in a single sport will make champions of all of our children. Worse — focusing early and often on one single sport may lead to overuse injuries, burnout, isolation, and a less likely shot at succeeding at and loving sports for a lifetime.

overuse-injuries-1

I think in the time of the tech boom we can also be led astray by the “Zuckerberg effect”  — the idea that we can only really change the world by focusing on a single thing and becoming a global master in doing so.

Reality is, those children who specialize in a single sport early are at higher risk for overuse injuries, burnout, quitting sports altogether and even isolation and loneliness. Successful, even elite athletes, are more likely to develop when our children don’t specialize in a single sport until late puberty, around age 15 or 16 years.  Read full post »

No More Antibacterial Soap At Home or School

It’s a clear no-go on those “antibacterial” soaps you see on people’s counters and sometimes in our schools. They are soon to vanish from stores. No good evidence the (typically liquid) soaps actually protect our family from bacterial infections better than washing with regular soap and water and there are some concerns the ingredients used to make the soap may pose risk. Because of this, the Food and Drug Administration (FDA) recently announced a ban on chemicals/pesticides used in antibacterial soaps due to safety concerns, including two of the most commonly used ingredients: triclosan and triclocarban. Some of these antibacterial soaps will still be used in hospitals.

Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water.” ~ Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation & Research

Some history: Back in 2013 the FDA asked companies that produce antibacterial soaps to prove that their products were more effective than basic soap and water. Turns out, they couldn’t (or didn’t) provide data to show that these products were safe for long-term use nor that they are more effective. We know anytime we add antibiotics into our environment. water, food or agriculture, they kill bacteria off so that bugs that are less treatable with medicines have an easier time surviving. The end result are so-called, “superbugs” or bacteria in our environment and thankfully, rarely in our bodies, that are difficult or impossible to treat. That’s a LOSE-LOSE for humans (and animals). Hence the new ban on these soaps. Companies now must comply with removing the chemicals within 1 year’s time, or take the products off the market. There are 3 chemicals used in some soaps still allowed (not included in the 19 ingredients listed in the FDA ban) that rarely may still be found.

Why We Don’t Want To Use “Antibiotic” Soap

Some bacteria are good (the ones that live in our guts and the ones that live on our skin, for example) and contribute to our microbiome. We want to preserve those as these bacteria protect us, help us break down food, and even support vitamin production. There is also some data that every course of antibiotics we ever take changes this microbiome and may have lasting and long-term effects including susceptibility to chronic disease.

So as part of our wellness relies on these “good” bacteria, part of human wellness also relies on effective antibiotics against the bad ones (for serious infections, surgery, when an immune system is compromised). Clearly, we only want to use antibiotics when necessary; if we overuse them we create environments where resistant bacteria thrive. Once that happens, we won’t be able to cure infections they cause. Read full post »